Division of Infectious Diseases, University of Pittsburgh Medical Center, Pittsburgh, PA 15213, USA.
J Clin Rheumatol. 2011 Oct;17(7):380-2. doi: 10.1097/RHU.0b013e318236e499.
Nontypeable Haemophilus influenzae is a rare cause of septic arthritis in adults and has been reported to be associated with underlying medical conditions. We present a case of nontypeable H. influenzae-infected severe invasive polyarticular septic arthritis in a young adult without any underlying predisposing medical conditions. Diagnosis was made from both positive blood culture and joint aspiration culture. The patient was successfully treated with employment of aggressive surgical debridement of multiple affected septic joints as well as prolonged antibiotic treatment. Further laboratory testing did not reveal significant underlying medical conditions including negative HIV, normal levels of complement and IgG subclasses, and normal-appearing spleen on computed tomography. This case illustrates that nontypeable H. influenzae can cause serious invasive septic arthritis infection in both patients with and without predisposing underlying medical conditions and that prompt diagnosis with aggressive treatment of combined surgical and medical treatment can result in optimal recovery.
无乳链球菌是成人脓毒性关节炎的罕见病因,据报道与潜在的医疗条件有关。我们报告了一例年轻成人无潜在易患医学条件的非典型性流感嗜血杆菌感染的严重侵袭性多关节脓毒性关节炎。诊断是通过阳性血液培养和关节抽吸培养得出的。该患者通过积极的手术清创多个受累的脓毒性关节以及长期抗生素治疗成功治愈。进一步的实验室检测未发现明显的潜在医疗条件,包括 HIV 阴性、补体和 IgG 亚类水平正常以及计算机断层扫描显示脾脏正常。该病例说明,无乳链球菌可导致有和无潜在医疗条件的患者发生严重的侵袭性脓毒性关节炎感染,及时诊断和积极的手术及药物治疗可以获得最佳的康复效果。